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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 5/2024

05-04-2024 | Splenectomy | Clinical Investigation

Partial Splenic Embolization in Paediatric Sickle Cell Disease Patients with Hypersplenism

Authors: Jacques A. Bazeboso, Didier Mbuyi Mukendi, Cissé-Luc Mbongo, Wilfrid Mbombo, Michel Lelo Tshikwela, Antoine Molua, Benjamin Longo, Léon Tshilolo, José I. Bilbao

Published in: CardioVascular and Interventional Radiology | Issue 5/2024

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Abstract

Purpose

To assess the safety and efficacy of partial splenic embolization (PSE) to reduce the need of transfusions and improve hematologic parameters in patients with hypersplenism and sickle cell disease (SCD).

Material and Methods

This prospective study includes 35 homozygous hemoglobin S patients with SCD and hypersplenism who underwent PSE from 2015 until 2021 in Kinshasa. Patients were evaluated, before and after PSE (1, 3 and 6 months), using clinical, laboratory and ultrasonographic methods. PSE was performed with the administration of gelatin sponge particles embolizing 60–70% of the splenic parenchyma.

Results

The mean age was 10 (± 4) years and (21/35, 60%) were male. After PSE Leucocytes decreased at 3 months (16 692.94 vs 13 582.86, p = 0.02) and at six months Erythrocytes increased 2 004 000 vs. 2 804 142 (p < 0.001), Platelets increased (168 147 vs. 308 445, p < 0.001) and Hemoglobin increased (5.05 g/dL vs. 6.31 g/dL, p < 0.001) There was a significant dicrease in the need of transfusions from 6 (2–20) before PSE to 0.06 (0–1) after PSE (p < 0.001). The most frequent complication was splenic rupture (4/35, 11.4%), seen only and in all patients with hypoechogenic nodules at baseline.

Conclusion

PSE is a safe procedure in patients with SCD and hypersplenism, that do not have hypoechogenic nodules in the spleen. PSE improves the hematological parameters and reduces the frequency of blood transfusions.

Graphical Abstract

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Metadata
Title
Partial Splenic Embolization in Paediatric Sickle Cell Disease Patients with Hypersplenism
Authors
Jacques A. Bazeboso
Didier Mbuyi Mukendi
Cissé-Luc Mbongo
Wilfrid Mbombo
Michel Lelo Tshikwela
Antoine Molua
Benjamin Longo
Léon Tshilolo
José I. Bilbao
Publication date
05-04-2024
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 5/2024
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-024-03701-4

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